Eye Care Transformation Programme - PowerPoint Presentation

1. Eye Care Transformation Programme briefingJune 2022For more information contact b.reis-seymour@nhs.net 

2. The health and care system in Shropshire, Telford and Wrekin is planning to transform local eye-care services.The aim is to provide effective eye-care services that are more joined up so that adults and children get the best care possible when and where they need it.We want to improve the experience of patients and staff working in eye-care services by looking at the way people access care, how they manage their eye conditions, and how the services work together, share information, and provide good patient care.Insight gathered through early engagement with the public and clinicians is helping to shape the future model of care.Key areas of work that will be included in the eye-care transformation programme are: Referrals processesOutpatients’ transformationIntegrated pathways across Primary/Community/Secondary eye-care and links with social careMulti-Speciality pathways Areas of work not included in the programme:Ophthalmology Surgery Eye related Cancer CareIdentify areas of focus and recommendations based on the engagement insightShare the report with the design group to inform design and development of future eye-care servicesPublish the engagement report and summary to share with those engaged and wider stakeholders including an update on next stepsOngoing communication and engagement, including engagement on any new proposalsEye Care Transformation Programme - summary

3. To anticipate the increasing need for servicesTo reduce unnecessary face to face outpatient appointmentsTo enhance the early detection and prevention of eye related conditionsTo provide more joined up services across primary, secondary and community careTo provide more services closer to home, when its neededTo make better use of new technologies and developments in eye careTo make better use of available data and be able to track people’s careReasons for change

4. April 2021July 2021May 221Sept 20212022 +2021 - 22 Nov 2021Dec 2021Early Engagement262 responses to our surveyOutreach sessions within eye care clinicsEngagement workshops with the public, NHS providers and independent providersCommunity outreach engagement

5. A good standard of careClinical StakeholdersThe clinical care which is provided is of a good standard, staff are engaged and there is a good level of trust between the optometrist and the patient.Patient and PublicPatients value the detail they are given about their condition, which gives confidence that they have been correctly diagnosed. Independent Sector Open and honest communication leads to the patient becoming an advocate of the service.Collaborative and AccessibleClinical StakeholdersOffering patient choice works well, collaborative working with the independent sector and the ability to share images all helps to improve the patient experience and ensure they are seen in a timely manner.Patient and PublicPatients tell us that there are direct links between their local optician and the hospital and that when the process works, patients find they are seen quickly and flexibly.  They find many of our facilities are suitable for them to access and navigate around.Independent Sector Collaboration between the independent sector and secondary care is important and is assisted by regular meetings with clinicians and operational leads working together, feedback loop between independent sector providers and hospital is keyWhat we heard: what works well

6. Maximise ResourcesClinical StakeholdersMake better use of the facilities and skills which are already within the system.Patient and PublicSupport from sight loss services in the community is sometimes offered too late in a person’s care. Better links are needed to mental health, local authority services, low vision clinics and sensory support teams.Independent SectorThe independent sector could offer much more, good communication can help to dispel the myths that they only pick the low hanging fruit.Better CommunicationClinical StakeholdersSome patients who have undergone treatment in hospital are unsure who to see post-op - better communication to patients pre and post procedures. Patient and PublicServices do not feel joined up, Text messages for those with sight loss can be difficult, lots of multiple confusing appointments, not always clear that the independent sector provider is commissioned by the NHS. Improved aftercare information in a variety of formats.Independent SectorAll having access to the same patient information, accurate data collection can be a struggle to make the case for change and makes it difficult to re-stratify patients.Strengthening of pathwaysClinical StakeholdersNo direct referral route, too many points where patients can get lost, convoluted and awkward. 2nd eye pathway is very complex. having to attend different settings for different procedures.Patient and PublicRepetition of tests and checks, delayed and long waits for appointments can lead to unnecessary falls and other complications, lack of consistency due to changes to services.Independent SectorSeamless pathways into and out of secondary care, consistent outcome measures for everyone, ensuring patients do not need other procedures prior to coming to us, easier referral routes, sometimes don’t not feel an equal partner within the pathway.Minor Eye Conditions Service (MECS)Clinical StakeholdersA smoother pathway between primary and secondary care, better administration - patients should not have to contact numerous practices to get an appointment.  Capacity issues and tariff can make it difficult for primary care optometry. Patient and PublicClarity is needed on the provision of emergency eye care (MECS, urgent eye clinic in Telford, weekends and bank holidays, ease of access, clear signposting and better informed), optometrist capacity for MECS appointmentsWhat we heard: what could be improved

7. Care closer to home / Embracing TechnologyClinical StakeholdersCapturing diagnostics in the community, virtual reviews. Allow procedures to be carried out in any location by anyone with the appropriate skills. Digital and Advice and Guidance underutilised - bring people together through multidisciplinary learning.Patient and PublicPatients would like greater access to clinical provision in the more remote areas of the county, with greater provision of services, and the suggestion of a roaming eye care clinic bus.Independent Sector ProvidersWork through the patient pathway and then decide who provides which services, the front end needs to be standardised allowing optometrists to undertake appropriate tests. patients don’t want to go to hospital or back into hospital for an eye procedure or appointment that can be done in their community.Holistic ApproachClinical StakeholdersNeed a holistic approach to the patient - treat the whole person.Patient and PublicNeeds to be about the whole person – holistic, not just a case or a condition. Access to practice advice, guidance and support during anxious times, easy to read leaflets, create a place where people can try and test different aids prior to purchase, At the moment people tend to get the clinical care and then they are referred – it should happen in parallel.Independent Sector ProvidersEnsure that patients have access to support information. What we heard: recommendations

8. Identify areas of focus and recommendations based on the insight captured from the engagement activitiesShare the insight with the design group to inform design and development of future eye-care servicesPublish the engagement report to share with those engaged and wider stakeholders including an update on next stepsOngoing communication and engagement, including engagement on any new proposalsNext steps

9. To read our public engagement report, please go to https://www.shropshiretelfordandwrekinccg.nhs.uk/get-involved/current-conversations/ Further information